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ISPCAN Jamaica 2018 (CIHRTeamSV) - Resilience in Youth: Presenting an App for Youth Experiencing Challenges


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Resilience in Youth: Presenting an App for Youth Experiencing Challenges
Christine Wekerle, Savanah Smith (CIHRTeamSV)

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ISPCAN Jamaica 2018 (CIHRTeamSV) - Resilience in Youth: Presenting an App for Youth Experiencing Challenges

  1. 1. #ResilienceInYouth: Presenting an App for Youth Experiencing Challenge Child Maltreatment, Substance Abuse and Interventions Symposium 2nd ISPCAN Caribbean Conference December 2018 Montego Bay, Jamaica Dr. Christine Wekerle, Department of Pediatrics, McMaster University Savanah Smith, Department of Pediatrics, McMaster University #CIHRTeamSV: risks-and-promoting-resilience-in-male-youth-with-sexual-violence-experience- CIHR-Team-Grant-TE3-138302
  2. 2. Resilience: Legal and Rights Frameworks UN Convention on the Rights of the Child1 o Calls for countries to develop legislation and implement services to protect the rights of children o Prevent violence and promote wellbeing (resilience) o Canada is a signatory country o The reporting of child abuse and neglect is mandated in all provinces and territories within Canada (Child, Youth, and Family Services Act)2 o In Ontario, Age of Protection: Raised to include 16 and 17 year olds3 o Yet, 1/3 of Canadians report experiencing abuse before age 16 (physical, sexual, and exposure to Intimate Partner Violence)4 o The majority of victims (67%) report not speaking to anyone about the abuse (i.e., family, friends, authorities)5
  3. 3. Positive Psychology  Moves beyond disorder to optimal human functioning6  Positive experiences, states and personal traits all contribute to wellbeing  Emphasizes the improvement of the individual7  Asks the question: What allows for resilience?
  4. 4. Could a mobile-app intervention bolster resilience in youth?  Reports show that one quarter of Grade Four students have a smartphone—with increasing numbers by grade until Grade Eleven, with 85% owning a smartphone8  Youth typically spend 6-9 hours online per day9  54% of teens report that they spend “too much” time on their cellphones10  What if they were using even a fraction of this time to focus on the positives and learn tools to increase resilience?
  5. 5. The JoyPop AppGoals: (1)Promote positive emotionality and activity (2)Promote safe social connectedness (3)Provide support with day-to-day stressors and periods of transition11-15 Psychological processes targeted: Executive Functioning: A set of higher-order processes in the brain that allow an individual to respond to external stimuli with goal- oriented action16 Emotion Regulation (ER): A set of processes that enable an individual to organize, manage, or modify their emotions (to positively adapt to internal or external cues)17 Recommended Usage: Minimum of twice daily (Once in the morning and once at night) Support is always available: Call for help button allows the user to access three helplines (i.e., Kids Help Phone, LGBT, Indigenous) should they feel distressed at any point in the day
  6. 6. When the App is first opened daily: (1) the Guide to Diaphragmatic Breathing; (2) Breathing Activity – Prompts Choice of Balanced or Relaxation Breathing; (3) Happy Mood Rating
  7. 7. Controlled Breathing Exercises o Teach user diaphragmatic breathing techniques to decrease stress and restore body to a resting state o Two Options: Balanced and Relaxation breathing o Preset timing and rounds of breathing with text prompt and visual tracking diagram o Some evidence that focused breathing exercises may have positive effects on the utilization of ER strategies18
  8. 8. Landing Page and Calendar  Focus is on the positives  Landing page allows the user to access all of the app features of Calendar; Mood Rating; Journaling; Activities [Art, Breathing, ShapeShifter Game]; Circle of Trust  Calendar keeps journal entries
  9. 9. Expressing Resilience via Journaling o Express thoughts, feelings, and emotions through words (and emojis) o User is able to journal free flowing thoughts, or respond to a pre- populated question, prompts or quote related to resilience o Research has demonstrated positive health and behavioral outcomes after participating expressive journaling interventions including improvements in physical and mental health, higher grades, elevated mood, and reductions in distress symptoms19-23
  10. 10. From Mood Ratings to Actions o User is first asked to rate happiness by sliding colour up or down with their finger o If rating is under 50% happy, user is asked to rate how sad, angry, or ‘meh’ they feel o JoyPop will provide a prompt for an activity to increase mood o Consistent mood imbalance and emotional suppression can lead to poor mental health, negative mindset, resulting behavioral issues35 o Teaches the user to be better aware of their emotions, identify and differentiate emotions, and create positive strategies to improve mood (ER)24
  11. 11. Gaming for Focus: ShapeShifter o Strategy games have been linked to self- regulation when played consistently over time25 o Tetris has been shown to decrease traumatic memory flashbacks26,27 o There is evidence that playing Tetris may have positive effects on spatial working memory28
  12. 12. Safe Social Connecting: Circle of Trust o Allows user to input up to six contacts to call when they are in need of support o May contain family, peers, social workers, mental health professionals, and mentors o Establishing positive relationships has been shown to decrease stress symptoms and increase relational learning29 o Adult mentors help to shape “resilient identity” of at-risk youth30 o Youth need to know that they are trusted to make decisions, but help is always available when they need it
  13. 13. Next Steps  The app is currently being studied on populations of youth transitioning from high school to university  Canadian child welfare foundation has partnered with communication firm, Telus, to provide 2 year data plan free to youth exiting system  Adaptation of the app to fit the resilience needs of Indigenous communities (i.e., holistic features, “water tool”, language)
  14. 14. FUTURUM Articles: Man Box: the-manbox JoyPop: wekerle-finding-joy-in-an-app Resilience Activity Sheet:
  15. 15. References 1) 2) 3) 4) Public Health Agency of Canada. (2018). Family violence: How big is the problem in Canada? Ottawa, Ontario: PHAC. Retrieved from: familyviolence/problem-canada.html?_ga=2.162634684.125106970.1528920153-1668390544.1528920153 5) Burczycka, M. (2017) Section 1: Profile of Canadian adults who experienced childhood maltreatment. Ottawa: Statistics Canada. Retreived from: x/2017001/article/14698/01-eng.html 6) Sheldon, K. M., Fredrickson, B., Rathunde, K., Csikszentmihalyi, M., & Haidt, J. (2000). Positive psychology manifesto. Manifesto presented at Akumal 1 conference and revised during the Akumal 2 meeting. Retrieved from: 7) Fredrickson, B. L. (2003). The value of positive emotions: The emerging science of positive psychology is coming to understand why it’s good to feel good. American Scientist, 91(4), 330-335. Retrieved from: 8) Steeves, V. (2014). Young Canadians in a wired world, Phase III: Trends and recommendations. Ottawa, Ontario: MediaSmarts. Retrieved from: 9) Common Sense Media. (2015). The Common Sense census: Media use by teens and tweens. Common Sense Media. Retrieved from: media-use-by-tweens-and-teens 10)PEW Research Center. (2018). How teens and parents navigate screen time and device distractions. PEW Research Center. Retrieved from: navigate-screen-time-and-device-distractions/
  16. 16. 11)Dumont, M., & Provost, M. A. (1999). Resilience in adolescents: Protective role of social support, coping strategies, self-esteem, and social activities on experience of stress and depression. Journal of Youth and Adolescence, 28(3), 343-363. doi: 10.1023/A:1021637011732 12)Kitano, M. K., & Lewis, R. B. (2005). Resilience and coping: Implications for gifted children and youth at risk. Roeper Review, 24(4), 200-205. doi: 10.1080/02783190509554319 13)Smith, C., & Carlson, B. E. (1997). Stress, coping, and resilience in children and youth. Social Service Review, 71(2), 231-256. Retrieved from: 14)Ungar, M. (2011). Social ecologies and their contribution to resilience. In M. Ungar (Ed.), The Social Ecology of Resilience (pp. 13-31). New York, NY: Springer. 15)Flett, G., Flett, A., & Wekerle, C. (2015). A conceptual analysis of interpersonal resilience as a key resilience domain: Understanding the ability to overcome child sexual abuse and other resilience interpersonal contexts. International Journal of Child and Adolescent Resilience, 3(1), 4-33. Retrieved from: http://in- 16)Hughes, C. (2013). Executive function: Development, individual differences, and clinical insights. In J. L. R. Rubenstein & P. Rakic (Eds.), Neural Circuit Development and Function in the Brain (pp. 429-445). Oxford, UK: Academic Press. doi:10.1016/B978-0-12-397267-5.00062-5 17)Hilt, L. M., Hanson, J. L., & Pollak, S. D. (2011). Emotion dysregulation. Encyclopedia of Adolescence, 3, 160-169. Retrieved from: 18)Arch, J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behavior Research and Therapy, 44(12), 1849-1858. doi:10.1016/j.brat.2005.12.007 19)Frisina, P. G., Borod, J. C., & Lepore, S. J. (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. The Journal of Nervous and Mental Disease, 192(9), 629-634. doi:10.1097/01.nmd.0000138317.30764.63
  17. 17. 20)Pennebaker, J. W., & Chung, C. K. (2007). Expressive Writing, Emotional Upheavals, and Health. In H. S. Friedman & R. C. Silver (Eds.), Foundations of Health Psychology (pp. 263-284). New York, NY, US: Oxford University Press. 21)Smyth, J. M. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66, 174-184. doi:10.1037/0022-006X.66.1.174 22)Sloan, D. M. & Marx, B. P. (2004). A closer examination of the structured written disclosure procedure. Journal of Consulting & Clinical Psychology, 72(2), 165-175. doi:10.1037/0022-006X.72.2.165 23)Lumley, M. A., & Provenzano, K. M. (2003). Stress management through written emotional disclosure improved academic performance among college students with physical symptoms. Journal of Educational Psychology, 95(3), 641-649. doi:10.1037/0022-0663.95.3.641 24)Desmet, P. M. A., Vastenburg, M. H., & Romero, N. (2016). Mood measurement with Pick-A-Mood: Review of current methods and design of a pictorial self-report scale. Journal of Design Research, 14(3), 241-279. doi:10.1504/JDR.2016.079751 25)Gabbiadini, A., & Greitemeyer, T. (2017). Uncovering the association between strategy video games and self-regulation. Personality and Individual Differences, 104,129-136. doi:10.1016/j.paid.2016.07.041 26)Holmes, E. A., James, E. L., Coode-Bate, T., & Deeprose, C. (2009) Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive-science. PloS ONE, 4(1), e4153. doi: 10.1371/journal.pone.0004153 27)James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2009). Computer game play reduces intrusive memories of experimental trauma via reconsolidation update mechanisms. Psychological Science, 26(8), 1201-1215. doi: 10.1177/0956797615583071 28)Bikic, A., Christensen, T. Ø., Leckman, J. F., Bilenberg, N., & Dalsgaard, S. (2017). A double-blind randomized pilot trial comparing computerized cognitive exercises to Tetris in adolescents with attention deficit/hyperactivity disorder. Nordic Journal of Psychiatry, 71(6), 455-464. doi:10.1080/08039488.2017.1328070
  18. 18. 29)Wekerle, C., Waechter, R., & Chung, R. (2012). Contexts of vulnerability and resilience: Childhood maltreatment, cognitive functioning and close relationships. In M. Ungar (Ed.), The Social Ecology of Resilience (pp.187-198). New York, NY: Springer. 30)Ungar, M. (2004). The importance of parents and other caregivers to the resilience of high-risk adolescents. Family Process, 43(1), 23-41. doi:10.1111/j.1545-5300.2004.04301004.x